CHIEF, HEALTH INSURANCE AND MANAGED CARE
|Department||Maryland Insurance Administration|
|Date Opened||1/10/2020 3:45:00 PM|
|Salary||$68,901.00 - $96,862.00/year (Salary Guidelines Apply to State Employees)|
|HR Analyst||Carla Harrison|
The Maryland Insurance Administration (MIA) is an independent State agency that regulates Maryland’s insurance industry and protects consumers by monitoring and enforcing insurers’ and insurance professionals’ compliance with State law. Through the diligence of a highly professional staff of market analysts, financial analysts, accountants, lawyers, law enforcement officers, actuaries, complaint investigators, and others, the MIA works to facilitate a strong and competitive insurance marketplace where consumers are well informed and treated fairly. Staff members are subject matter experts who serve as a resource for lawmakers, consumers, and other public and private entities.
The MIA is charged with a broad range of responsibilities including the licensure of insurance carriers and insurance producers (brokers/agents) operating in Maryland, the conduct of financial examinations of companies to monitor financial solvency, and the review and approval of rates and contract forms. The MIA investigates reports of consumer fraud and consumer complaints about life, health, automobile, homeowners, and/or property insurance. Insurance carriers are subject to market conduct examinations and other actions to monitor compliance with Maryland law. The MIA also has a unit dedicated to consumer education and outreach, which participates in hundreds of events and reaches thousands of individual consumers annually.
* This is a Management Service position that serves at the pleasure of the appointing authority. *
LOCATION OF POSITION
The Maryland Insurance Administration is recruiting for the position of Chief, Health Insurance and Managed Care in the Life and Health Division. This position provides leadership regarding health insurance and Health Maintenance Organization (HMO) related issues for the Division. The Chief assists the Associate Commissioner of Life and Health with the implementation of the Affordable Care Act (ACA) and provides guidance to staff on the impact of the ACA on policy form review. This position oversees the management of the Life and Health Division’s Health Review and the Managed Care Units, which are responsible for the review and approval of all health and managed care contracts in Maryland, including provider contracts. This position also assigns Utilization Review Analysts new and renewal Private Review Agent (PRA) and Medical Director applications for review to determine compliance with Maryland laws and regulations, and evaluates the quality of review performed. This position assists the Associate Commissioner of Life and Health with the analysis and interpretation of proposed state and federal legislation and regulations, and acts as the Associate Commissioner’s designee, if needed, at meetings and by providing testimony during the legislative session. The Chief is responsible for integrating new legislation and regulations into the form review process and PRA and medical director certification process, and assisting with the drafting of any necessary regulations, bulletins, checklists, and training materials for staff. The Chief advises the Associate Commissioner of Life and Health on numerous health insurance issues impacting consumers and insurance carriers, and answers technical questions from consumers, insurance carriers, and MIA staff regarding filing requirements and other complex health insurance issues.
Education: Possession of a bachelor’s degree from an accredited college or university.
Experience: Eight years of experience analyzing contracts, services, or programs for compliance, with a health insurer, managed care organization or insurance regulatory agency; one year of that experience must have been in a supervisory capacity.
Note: The requirements indicated below are acceptable substitutions to the above minimum requirements:
1. Possession of a master's degree in a related field or a law degree; and six years of experience analyzing contracts, services, or programs for compliance, with a health insurer, managed care organization or insurance regulatory agency; one year of that experience must have been in a supervisory capacity.
2. Possession of a bachelor's degree and a Fellow, Life Management Institute (FLMI) or equivalent designation; and five years of experience drafting or analyzing contracts, services, or programs for compliance, with a health insurance insurer, managed care organization or insurance regulatory agency; one year of that experience must have been in a supervisory capacity.
DESIRED OR PREFERRED QUALIFICATIONS
Preference will be given to applicants who possess the following preferred qualification(s). Include clear and specific information on your resume regarding your qualifications.
· Knowledge of Maryland Insurance laws and regulations.
· Expert knowledge of the Affordable Care Act.
· Excellent written and verbal communication and organizational skills.
· Strong analytical and logical reasoning skills with experience reviewing and interpreting complex written documents
Click on a link below to apply for this position:
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|Apply via Paper Application.||You may also download and complete the Paper Application here.|